title: K2 toxicity: fatal case of psychiatric complications following AM2201 exposure.
abstract: Limited forensic and clinical experience and the lack of confirmatory testing strategies for synthetic cannabinoids (SC) prevent adequate characterization of SC toxicity and the potential impact on public health. A statewide surveillance system identified a fatality involving a 23-year-old man found with a large stab wound to the neck following use of a SC product suspected of containing AM2201. Analytical testing for common SCs, SC metabolites, routine drugs of abuse, and over-the-counter medications was performed on heart blood obtained at autopsy. Additionally, assays were performed on the SC raw material and drug paraphernalia found on the decedent. High concentrations of AM2201 were detected in all samples. AM2201 metabolites were detected in postmortem blood. Other than a trace amount of JWH-073 found in smoke residue, no other substances were detected. Psychiatric complications including self-induced, lethal trauma can occur after the use of SC products.
authors.affiliation: Public Health Laboratory, Arkansas Department of Health, Little Rock, AR, 72205.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Patton
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Chimalakonda
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Moran
authors.forename: Keith R
authors.initials: KR
authors.lastname: McCain
authors.forename: Anna
authors.initials: A
authors.lastname: Radominska-Pandya
authors.forename: Laura P
authors.initials: LP
authors.lastname: James
authors.forename: Charles
authors.initials: C
authors.lastname: Kokes
authors.forename: Jeffery H
authors.initials: JH
authors.lastname: Moran
mesh_terms: D002853:Chromatography, Liquid; D017809:Fatal Outcome; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects* / Q000032:analysis; D007211:Indoles / Q000009:adverse effects* / Q000032:analysis; D008297:Male; D013058:Mass Spectrometry; D009281:Naphthalenes / Q000032:analysis; D019838:Neck Injuries / Q000209:etiology / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000139:chemically induced* / Q000523:psychology; D014951:Wounds, Stab / Q000209:etiology / Q000523:psychology*; D055815:Young Adult
chemical_list: C582337:1-(5-fluoropentyl)-3-(1-naphthoyl)indole; D013287:Illicit Drugs; D007211:Indoles; D009281:Naphthalenes; C552597:1-pentyl-3-(1-naphthoyl)indole
keywords: AM2201; K2 toxicity; designer drugs; drug metabolism; forensic science; forensic toxicology; human fatality; spice toxicity; synthetic cannabinoid